A condition known as hemolytic disease of the newborn (HDN) occurs when the body destroys red blood cells faster than it can replace them in a fetus or newborn. HDN is explained in detail here, including its causes, symptoms, diagnosis, treatment, and prevention.
Causes
Most commonly, HDN is caused by blood group incompatibility between the mother and the fetus.
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The mother's immune system may produce antibodies against the Rh-positive red blood cells if she carries an Rh-positive fetus.
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When the mother has type O blood and the fetus has type A or B blood, the mother's immune system may attack the fetal red blood cells.
Symptoms
HDN symptoms can vary in severity and include:
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High bilirubin levels cause yellowing of the skin and eyes.
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A low red blood cell count causes fatigue, pallor, and weakness.
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As the liver and spleen produce more red blood cells, they enlarge.
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The accumulation of fluid in the tissues of the body causes swelling.
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The high oxygen demand in severe cases can lead to heart failure.
Diagnosis
There are several steps and tests involved in diagnosing HDN:
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Screening for blood type and Rh factor, as well as levels of antibodies in the blood of pregnant women.
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In fetal monitoring, ultrasounds and Doppler studies are performed to assess the health of the fetus.
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Analyzing bilirubin levels in amniotic fluid to determine the severity of hemolysis through amniocentesis.
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To assess anemia and bilirubin levels in fetal blood, cordocentesis is performed.
Treatment
HDN is treated according to its severity:
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Using light to break down bilirubin in the newborn's skin, phototherapy treats jaundice.
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An exchange transfusion reduces the newborn's bilirubin levels and treats anemia by replacing damaged blood with fresh donor blood.
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By reducing maternal antibodies, intravenous immunoglobulin (IVIG) reduces the need for exchange transfusions.
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A transfusion of blood directly into the fetus in severe cases of anemia before birth is called intrauterine transfusion.
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Monitoring and managing complications such as heart failure and infection as part of supportive care.
Prevention
HDN can be prevented primarily by managing Rh incompatibility:
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During and after pregnancy, Rh immunoglobulin (RhoGAM) is administered to Rh-negative mothers to prevent the development of antibodies against Rh-positive blood cells.
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Screening for blood type and Rh factor in pregnant women to determine HDN risk.
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Providing regular prenatal care to monitor the health of the mother and fetus, ensuring early detection and management of potential complications.
Conclusion
As a result of blood group incompatibility between mother and fetus, hemolytic disease in newborns is a serious condition. Managing HDN requires understanding its causes, recognizing its symptoms, and following appropriate diagnostic and treatment protocols. It is possible to reduce the incidence and severity of this condition significantly by taking preventive measures, especially in cases of Rh incompatibility. Both mother and child benefit from comprehensive prenatal care and early intervention.
